Signs & Symptoms of Ecstasy Abuse

In the 2022 National Survey on Drug Use and Health, 3% of people 12 and older used hallucinogens like ecstasy. Rates were highest among people ages 18 to 25, and people who were multiracial or white were more likely to use these drugs.  

Signs of ecstasy addiction include a focus on getting and using the drug, deterioration in other areas of life (such as work, school, family relationships, and physical appearance), and an inability to stop use despite a desire to do so.

What Are the Most Common Signs & Symptoms of Ecstasy Abuse?

Also known as MDMA (3,4-methylenedioxymethamphetamine) or Molly, ecstasy is a semi-synthetic drug. It is illicitly manufactured and a Schedule I narcotic because it is addictive and not used medically. 

The effects of ecstasy vary depending on the individual, but they may include feelings of euphoria, increased energy and pleasure, decreased anxiety and inhibitions, and distorted sensory perceptions. These effects typically last for three to six hours after taking a single dose of the drug. 

This chart can help you understand the short-term symptoms and long-term risks of ecstasy abuse.

If you notice these symptoms, someone may be on ecstasy:

Increased Energy & Talkativeness

Users are often highly energetic and animated. This gives them the ability to dance and party for hours. Because of these effects, ecstasy is commonly used at raves, nightclubs, and parties.

Emotional Closeness

The drug suppresses activity in the part of the brain called the amygdala, the section that makes a person feel stressed, anxious, or fearful. Because of this, the drug produces prosocial and empathetic feelings toward others — feelings that reduce anxiety created from interacting with others. Increased levels of serotonin, a neurotransmitter, which gives people a feel-good feeling, is also responsible for this response.

This feeling of emotional closeness can sometimes lead to unsafe sexual activities, as the person’s inhibitions break down and they feel more emotionally close to others.

Enhanced Senses

Ecstasy causes enhanced senses. Some people report that colors seem more vivid, and the body is more sensitive to touch. As sounds are heightened, music can feel more intense and enjoyable. 

Decreased Appetite

MDMA is known to decrease appetite. Studies show that this is one of the adverse health effects of using the drug. As a result, people who use the drug regularly may lose weight.

Impaired Judgment

Because people experience an elevated mood, or feelings of euphoria and emotional closeness, they may make  poor decisions about how they interact with people. Impaired judgment may lead to overdose as well, particularly when ecstasy is combined with other substances like alcohol or opioids. 

Users often use the drug at parties in crowded and hot venues where they’re physically active. This can lead to dehydration, electrolyte imbalances, spikes in the body temperature, high blood pressure, and, in some cases, a stroke or heart attack.

Other Symptoms of Abuse

Other symptoms of ecstasy abuse include the following:

• Grinding of the teeth or jaw clenching
• Distorted perceptions of time
• Enhanced self-esteem
• Euphoria
• Dilated pupils

Signs of Ecstasy Experimentation vs. Abuse

Ecstasy is a Schedule I drug under the Controlled Substances Act, so it has no currently accepted medical use in the United States. Technically, anyone who uses this drug is abusing it, as you can’t get a prescription for it or take it via a doctor’s orders. However, some people might be considered ecstasy experimenters and others chronic abusers.

This chart can help you understand the differences between the two groups:

How to Recognize an Ecstasy Addiction

If someone repeatedly uses ecstasy, an addiction can form. The primary sign of addiction is an inability to control use of ecstasy. You might want to cut back on ecstasy use because you see the issues it is causing in your life, but you are unable to do so.

Other signs of an ecstasy addiction include the following:

• Decline in physical health
• Fatigue
• Irritability
• Decline in performance at work or school 
• Relationship issues due to ecstasy use or lying about use
• Stealing money to buy ecstasy
• Being in risky situations in order to get or use ecstasy
• An obsessive focus on using the drug

What Are the Dangers of Ecstasy?

In 2020, researchers conducted a review of published studies about health problems and ecstasy. They pointed out that studies about ecstasy-related hospitalizations may not provide useful information. They wrote this: “Various ED studies have reported ecstasy-related hospital admissions e.g. (Dargan, 2008; EMCDDA, 2016; Horyniak et al., 2014; Rosenson et al., 2007; SAMHSA, 2013). However, these studies were generally small and without information on the (last-year) prevalence of ecstasy use in the patients included and in users who did not visit the ED, making it impossible to calculate the risk per user or per pill that was taken.”

The researchers did find that ecstasy abuse can lead to hospitalizations. The risk of a severe health incident following ecstasy is one in 900 pills, they said. By comparison, the risk for GHB is one in 95 doses.

Below are some of the major dangers associated with using the drug:

Contamination

Any use of ecstasy can be dangerous, particularly since the pills may be laced with other substances. It’s rare that ecstasy is pure, even if versions like Molly are advertised as such. Since the drug is illegal, you never really know what you are getting when you purchase it from a dealer.

In 2019, researchers published a study of contaminants found in pills taken from an electronic music dance festival. They found that most contained ecstasy (31%), but some contained cannabis (28%), and 6% contained what the researchers called a “new psychoactive substance.” One pill contained a known neurotoxic substance.

In 2023, officials in Los Angeles warned consumers that drugs sold as ecstasy contained the deadly opioid fentanyl instead. The warning came after three teenage girls bought pills they thought were ecstasy, and all three exhibited opioid overdose symptoms.

Increased Body Temperature

Ecstasy can cause the temperature to rise. When combined with hot, crowded environments in which it is often taken and dehydration, this can lead to organ failure and death. 

Heart Disease & Stroke

Because the drug increases the blood pressure, it can also affect the heart. This can potentially lead to a heart attack or circulatory problems that may trigger a stroke.

Decreased Cognitive Functioning

While taking ecstasy boosts mood, it also leads to cognitive deficits. A person who continues to take the drug may feel safe, even if they are in a dangerous situation. They may also have  problems with judging movement or have difficulty processing information. This can lead to accidents or injuries, and it can make them more likely to be a victim of a crime.

Users often feel overly confident, which can be dangerous if they get behind the wheel of a car. Their perception of motion is typically altered as well.

They may also be more likely to engage in unsafe sex, which can lead to the contraction of sexually transmitted diseases. 

Depression

With prolonged use, ecstasy increases depressive episodes. Depression is triggered by serotonin imbalances and can lead to problems with memory or focusing. This condition can continue for several years after stopping use of the drug.

Many people have issues with depression as they “come down” from ecstasy use. This can motivate them to use it again, promptly a dangerous cycle of continual abuse.

Serotonin Syndrome

Because ecstasy increases serotonin activity, a user may experience serotonin syndrome, which is also known as serotonin toxicity. The body has too much of a natural chemical, and it can cause very significant health problems.

When a person has serotonin syndrome, they may feel restless or confused, or they may experience rapid heart rate or high blood pressure. Their pupils may become dilated, and they may lose muscle coordination and control or experience muscle rigidity. 

This is a dangerous condition. Call 911 if you or a loved one is experiencing these symptoms.

Additional Risks

Other potential risks of ecstasy use include the following:

• Muscle cramping
• Anxiety
• Chills or sweating
• Irritability
• Impulsiveness
• Nausea
• Blurred vision
• Sleep difficulties
• Poor appetite
• Aggressiveness

Ecstasy Withdrawal Symptoms

It is unclear whether ecstasy can result in physical dependence, but psychological dependence can form, resulting in addiction. As a result, a person may experience withdrawal symptoms when they stop using the drug. 

The severity of symptoms will depend on personal factors, such as the intensity of use, duration of use, co-occurring mental health conditions, and overall physical health. Potential withdrawal symptoms from ecstasy include the following:

• Chronic fatigue
• Problems with sleep
• Memory issues 
• Focus problems 
• Mood swings and irritability
• Paranoia
• Hostility
• Depersonalization
• Sexual dysfunction
• Poor motor control and coordination
• Hallucinations 
• Confusion

How to Treat Ecstasy Overdose

Ecstasy overdose is possible, particularly if the tablets or pills were cut with an opioid, like fentanyl. 

If you notice any potential symptoms of overdose, call 911 immediately. You can also administer naloxone if you have it available since this will temporarily reverse an opioid overdose, potentially saving a life if the ecstasy was laced with opioids.

Symptoms of overdose include the following:

• Abnormal heart rhythm
• Overheating (hyperthermia)
• Excessive sweating
• Seizures
• Passing out

The Need for Help

If you or a loved one is abusing ecstasy, treatment is needed. Any use of ecstasy is problematic, but if it has developed to the point of addiction, professional care can help you stop using the drug and begin to build a better life.